HealthDay News — Inappropriate antibiotic prescribing for acute respiratory infections (ARIs) increases in the 12 months after removing behavioral interventions compared with control practices, according to a research letter published online October 10 in the Journal of the American Medical Association.

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During the baseline, intervention, and post-intervention periods, there were 14,753, 16,959, and 7,489 visits for antibiotic-inappropriate ARIs. The researchers found that the rate of inappropriate antibiotic prescribing decreased in control clinics from 14.2 to 11.8% during the post-intervention period (absolute difference, −2.4%). It increased from 7.4 to 8.8% (absolute difference, 1.4%) for suggested alternatives (difference-in-differences, 3.8% [95% confidence interval, −10.3 to 17.9%]; P=0.55), increased from 6.1 to 10.2% (absolute difference, 4.1%) for accountable justification (difference-in-differences, 6.5% [95% confidence interval, 4.2 to 8.8%]; P<0.001), and increased from 4.8 to 6.3% (absolute difference, 1.5%) for peer comparison (difference-in-differences, 3.9% [95 percent confidence interval, 1.1 to 6.7%]; P<0.005). Peer comparison remained lower than control (P<0.001; 1-tailed test) during the post-intervention period, while there was no difference for accountable justification versus control (P=0.99; 1-tailed test).